Preadmission testing (PAT) has been shown to reduce day-of-surgery delays and unnecessary testing that drive up the cost of healthcare. But it takes time and patience to put an effective PAT process in place. Sharon Ulep, MBB, CMCA, CPHQ, principal for healthcare strategy and consulting, Plante Moran, Southfield, Michigan, who…

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Not all hospitals have a preadmission testing (PAT) process, and even when they do, communication breakdowns and inefficiencies can make the process ineffective. Recognizing that the PAT process at Yale New Haven Hospital, New Haven, Connecticut, needed a makeover was the first step in launching an improvement project that led…

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Can hospital leaders and surgeons partner to reduce opioid use while maintaining high patient satisfaction scores? Leaders at OSS Orthopaedic Hospital in York, Pennsylvania, answer that question with a yes. Meghan McNelly, PharmD, MHA, FACHE, who was director of pharmacy at OSS when the opioid-reduction project started, says that from…

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Among the many variables that influence on-time starts of surgical cases are the arrival times of patients and staff, as well as the verifications and documentation required before patients are brought to the OR. Increasing on-time starts was a key initiative at Fox Chase Cancer Center. By exploring the influences…

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Editor's Note A simple 6-minute walking test before cardiac surgery helped predict the risk for cognitive issues after surgery, in this study from Japan. A 6-minute walk distance (6MWD) test was performed preoperatively on 181 patients who had nonemergency cardiac surgery. After surgery, 51 patients had postoperative cognitive dysfunction (POCD).…

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The government and insurance companies have imposed increasing penalties on healthcare facilities in recent years for readmissions. And with good reason: High readmission rates greatly increase costs and sometimes signal poor patient safety practices. In 2015, roughly 2 million patients were readmitted, costing Medicare $27 billion, according to the Centers…

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Editor's Note Dedicated OR teams for a colorectal Enhanced Recovery after Surgery (ERAS) program at Johns Hopkins Hospital led to anesthesia providers becoming more central to the ERAS network, which increased process measure compliance and improved clinical outcomes in this study. Before the dedicated OR teams were instituted, surgeons were…

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Editor's Note Patients who lose some weight before bariatric surgery achieve greater weight loss after surgery, and they have shorter procedures and hospital stays, this study finds. Those (224 patients) who lost 8% of their excess weight by following a 1,200 calorie diet for 4 weeks before their surgeries had…

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Editor's Note In this study, an interdisciplinary program that includes a coordinated approach by healthcare professionals in surgery, geriatrics, and anesthesiology was associated with improved postoperative outcomes for high-risk older patients having elective abdominal surgery. Compared with a control group (143 patients), older patients participating in the Perioperative Optimization of…

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Editor's Note Poor preoperative cognition, as assessed by preoperative Mini-Cog screening, is prevalent among older total joint patients and predictive of adverse outcomes, including postoperative delirium, longer hospital stay, and greater likelihood of discharge to a place other than home, this study finds. Of 211 patients 65 years of age…

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